Hypogonadotropic Hypogonadism and Gynaecomastia in the Young Adult: A Case Series

We present three cases who presented to our Endocrinology OPD a few days apart with the common complaints of no or minimal development of secondary sexual characteristics. Although they had similar problems, investigations revealed a spectrum of different clinical, biochemical and genetic abnormalities. All the patients had otherwise normal anterior pituitary hormone secretion and sellar anatomy. One had a short Y chromosome, one was a Klinefelter syndrome and the other had no chromosomal abnormality. These findings along with absence of any detectable abnormality on pituitary imaging helped us diagnose these cases as Idiopathic hypogonadotropic hypogonadism. Treatment with testosterone showed marked improvement at 1 year follow up.     

Effect of insulin on serum lipids in relation to nutritional status in diabetics

Serum levels of cholesterol, triglyceride, free fatty acid (FFA) and high density lipoprotein (HDL) cholesterol were studied in 10 undernourished and 10 better nourished diabetic patients at different periods of insulin treatment and in non-diabetic controls. Serum concentrations of cholesterol, triglyceride and FFA were significantly higher in untreated diabetic patients than in control but the elevated lipid levels gradually shifted towards normal on insulin treatment. The HDL cholesterol, on the other hand, was significantly lower in untreated diabetic subjects than those in controls and the HDL cholesterol also gradually modified on insulin therapy. However, the improvement of all the lipid parameters on insulin treatment was somewhat delayed in undernourished compared to those of better nourished diabetics. These results, therefore, suggest that malnutrition interferes with the serum lipid improvement in diabetics on insulin treatment and may make them more prone to develop vascular complications.     

Evolving strategies in whirlwind mode: The changing face of anatomy education during Covid-19 pandemic

The Covid-19 pandemic stipulated adoption of unfamiliar strategies for delivering anatomy education in online mode. The factors which determine education strategies are variable across geographical regions. It was perceived that an overview of education strategies around the globe would be useful for anatomists. Hence this narrative review was undertaken to collate observations from different geographical regions pertaining to education strategies adopted during the pandemic. Data relevant to the topic of study were extracted from 12 articles that were selected from an initial pool of 317 articles based on search criteria set for the review. Subtle differences in core education strategies implied that baseline response from anatomists was similar across regions. It was evident that online digital tools were key elements of education strategies adopted by educators for delivering online anatomy classes across the globe. Interestingly, a considerable gap in terms of number and variety of online tools used for anatomy education (those requiring commercial purchase) was noted between economically developed and developing regions. This may have an impact on learning outcome for students and may even lead to variations in anatomical knowledge by regions. It was observed that offline human dissection sessions were incorporated into online practical classes in one region as positive cases showed a declining trend. This positive development is worth emulating elsewhere based on cautious assessment of prevailing situation. From a broad perspective timely introduction of education strategies ensured delivery of anatomy education during the pandemic and gave an evolved outlook to the fabric of anatomy education.